Summary Of Breast Reconstructions Options

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Breast Implant/ Expander 

Advantages

  • Breast Implant / Expander

  • Short Operation

  • Good results are possible in selected cases

 

​Disadvantages

  • Limited size of breast due to lack of skin

  • Scar capsule problems

  • Implant infection

  • Implant exposure

  • May require Alloderm for implant coverage

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Breast Implant with Latissimus Dorsi Myocutaneous Flap 

​Advantages ​

  • Intermediate length procedure

  • Good results are possible

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Disadvantages

  • Implant infection

  • Scar capsule

  • Large back scar

  • Loss of muscle function

  • May require Alloderm for implant coverage

 

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Latissimus Dorsi Myocutaneous Flap

 

​Advantages 

  • Autogenous Tissue

  • Soft natural breast

  • Reliable blood supply

  • Fair to good size

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Disadvantages

  • Often limited breast size

  • Large back scar

  • Loss of muscle function

 

TRAM Myocutaneous Flap

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 Advantages

  • Autogenous Tissue

  • Soft natural breast

  • Reliable blood supply

  • Large breast mound

  • Abdominoplasty Closure

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 Disadvantages 

  • Includes some muscle and fascia

  • Abdominal weakness

  • Occasional need for mesh to support abdominal fascia repair

 

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Free TRAM, Transverse Rectus Abdominis Flap

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 Advantages

  • Autogenous Tissue

  • Soft natural breast

  • Excellent blood supply

  • Large breast mound

 

Disadvantages 

  • More complex procedure

  • Removes a little muscle and fascia

  • Abdominal weakness and hernia are less than with pedicle TRAM flaps

 

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DIEP, Deep Inferior Epigastric Perforator, Flap

​Advantages

  • Autogenous Tissue

  • Soft natural breast

  • Good to excellent blood supply

  • Large breast mound

  • Minimal violation of fascia and muscle

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Disadvantages 

  • More complex dissection than free TRAM

  • Cuts rectus abdominis fascia, and dissects through muscle

  • Potential abdominal hernia or weakness

 

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SIEP, Superficial Inferior Epigastric Perforator Flap

​Advantages

  • Autogenous Tissue

  • Soft natural breast

  • Good to excellent blood supply

  • Large breast mound

  • No violation of fascia or muscle

  • Abdominoplasty closure

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Disadvantages 

  • Complex dissection

  • Variable vascular pattern

 

S-GAP, Superior Gluteal Artery Perforator

Advantages

  • Autogenous Tissue

  • Soft natural breast

  • Good blood supply

  • Large breast mound

  • Well hidden scar

 

Disadvantages

  • Complex dissection

  • Requires patient position changes during surgery

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I-GAP, Inferior Gluteal Artery Perforator Flaps

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Advantages

  • Autogenous Tissue

  • Soft natural breast

  • Good blood supply

  • Large breast mound

  • Well hidden scar

 

Disadvantages

  • Complex dissection

  • Requires patient position changes during surgery

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